Lower back pain is one of the most common musculoskeletal complaints worldwide. It affects more than 80% of people at some point in their lives and can range from mild discomfort to severe, activity-limiting pain. Although most cases are not caused by serious underlying conditions and improve with simple measures, persistent pain should not be ignored, as it can significantly affect quality of life and daily function.
Lower back pain can result from mechanical, degenerative, or inflammatory conditions. In many cases, a precise cause cannot be identified. Common causes include:
Degenerative disc disease: Natural ageing leads to disc wear and tear, cracks, fluid loss, and possible bone spur formation.
Bulging or herniated disc: The disc may protrude or rupture, pressing on nearby nerves and causing sciatica (pain radiating down one leg).
Osteoarthritis: Degeneration of the facet joints that connect spinal bones may lead to pain and stiffness.
Spondylolisthesis: A vertebra slips forward over the one below it, causing back pain or nerve irritation.
Lumbar spinal stenosis: Narrowing of the spinal canal compresses nerves, causing pain, numbness, or weakness in the legs.
Ankylosing spondylitis: An inflammatory arthritis affecting the spine, leading to stiffness and, over time, fusion of the vertebrae.
Occupational strain: Poor posture, prolonged sitting or standing, long-distance driving, and improper lifting techniques can overwork spinal muscles and ligaments.
Although mild back pain often improves within a few weeks, you should seek medical evaluation if you experience:
Persistent pain lasting more than 4 weeks
Severe or worsening pain not relieved by rest or simple remedies
Pain radiating to one or both legs
Weakness, numbness, or tingling in the legs or feet
Unexplained fever or weight loss with back pain
Pain after a fall, accident, or direct injury
New-onset back pain in adults over 70 years old
These may indicate an underlying condition requiring prompt medical attention.
A comprehensive clinical assessment is the first step in diagnosing the cause of lower back pain.
Your doctor will ask about:
Onset, location, and severity of pain
Whether symptoms radiate to the legs
Any weakness, numbness, or bowel/bladder issues
Occupation, posture, physical activity, and previous injuries
Existing medical conditions
This includes assessment of:
Posture and gait
Range of spinal movement
Muscle strength
Reflexes
Sensory changes
Tenderness over the spine or muscles
Although imaging can help identify structural abnormalities, scans are not routinely required for most people with lower back pain. In many cases, back pain improves with conservative care, and imaging does not change management.
X-rays
Helpful for detecting:
Vertebral fractures
Osteoarthritis
Signs of spinal inflammation (e.g., ankylosing spondylitis)
Possible spread of cancer to the spine
CT Scans and MRI
Provide detailed images of bones and soft tissues. They may be recommended for:
Suspected spinal stenosis or disc herniation
Suspected infection or tumour
Persistent or severe pain beyond 4-6 weeks
When surgery is being considered
Treatment depends on the underlying cause and severity of symptoms. The goals are to reduce pain, restore mobility, and prevent recurrence.
Stay active: Gentle movement promotes faster recovery. Prolonged bed rest can weaken muscles and delay healing.
Heat therapy: A warm compress or heating pad relaxes muscles and relieves discomfort.
Workplace adjustments: Improving posture, using ergonomic seating, and taking regular breaks can reduce stress on the lower back.
Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce inflammation and pain. Muscle relaxants may be prescribed for short-term relief of muscle spasms.
Physiotherapy: A tailored programme can improve flexibility, core stability, posture, and movement patterns.
Lifestyle modifications: Maintaining a healthy weight, exercising regularly, practising good ergonomics, and managing stress contribute to long-term back health.
Surgery: Surgery is reserved for cases that do not respond to conservative measures or when nerve compression causes severe symptoms such as weakness or inability to walk long distances.
Simple preventive measures include:
Practise proper lifting techniques (bend at the knees, not the waist)
Maintain good posture when sitting, standing, and sleeping
Keep body weight within a healthy range
Exercise regularly, focusing on core and back strength
Use supportive footwear and ergonomically designed furniture
If back pain limits your mobility or interferes with your daily activities, it should be evaluated early. Timely assessment helps identify the underlying cause and ensures that appropriate treatment is initiated to prevent complications.
Book an appointment with our experienced orthopaedic specialist or orthopaedic surgeon at Prince Court Medical Centre in Kuala Lumpur today for a thorough evaluation and expert care to help you recover and regain an active, pain-free lifestyle.
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